A procedure usually done in the office in which both vas deferens (tubes that transport sperm) are ligated and/or divided to provide permanent male sterilization.
There are many reasons I see men choosing a vasectomy. The most common is that they have been helped in this decision by their wives. A vasectomy is a permanent but not immediate form of birth control After a confirmed negative sperm count (usually done 3 months after the procedure) the rate if failure is about 1 in 2000 men. Some advantages are that it is a minimally invasive procedure done in the office, with only short term discomfort, easily able to be confirmed (sperm analysis), and well tolerated. Most other permanent female birth control options are more invasive and often require either more difficult confirmatory tests or whole body anesthesia.
The vasectomy technique has been around for over 100 years. Over time it has been modified and improved with the advent of specialized instruments. A traditional vasectomy involved 1-3cm incisions on both side of the scrotum to isolate and then ligate/divide the vas. The more modern ‘minimally invasive’ or ‘no scalpel’ techniques involve either one or two incisions in the scrotum 1cm or less and minimal manipulation around the vas. Some studies have shown that a single incision may reduce pain and operative time so this is often favored over two incisions.
I use a minimally invasive technique where after injections with a fine needle, a single, no scalpel opening is made in the midline of the scrotum. The opening is usually only several millimeters long and through this with minimal manipulation the vas is dissected out and then ligated and divided.
With any procedure there are always the possible risks of infection or bleeding. There are also several reported but rare complications. All three blood supplies to a testicle could be disrupted causing a testicle to atrophy. Some people have also reported chronic pain in the area persisting after the procedure and want another surgery to alleviate this.
In my experience it is very uncommon to experience anything more than skin bruising, a few days of mild pain, and discomfort that has usually subsided by the two week follow up. I have also never seen testicular atrophy or chronic scrotal pain in my practice.
If you adhere to some common guidelines recovery is usually very rapid. Rest, ice and anti-inflammatories are important the first several days. A tight scrotal support can be helpful for the first two weeks. Strenuous activity and sexual activity should be avoided for one week. Most men have only minor pain but are able to go about their routine even during the first several days after the procedure. At the two week follow up most are back to their usual activities and routine with only occasional reminders of having a recent procedure.